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Burning issues.

Burning issues.

Acidity is a huge topic in dentistry, but often having acid reflux is grossly overlooked. Acid reflux is the backward flow of stomach acids into the esophagus or the food tube. GERD (gastroesophageal reflux disease) is said to be a more severe form of acid reflux. Having acid reflux can cause heartburn, irritations, a sour taste in the back of the throat, and much more. Because I am not a professional on the matter, I do not think I am the best person to explain the causes, symptoms, and treatments for acid reflux. I am, however, an expert on oral conditions pertaining to patients.

As stated before, acid reflux causes stomach acid to regurgitate into the tube connecting the mouth to the stomach. Healthline.com stated that approximately 60% of adults experience some sort or acid reflux! That is a lot of acid to worry about! The concern in dentistry is that stomach acid can (and does) very easily erode tooth enamel.

The exposure to stomach acid in the mouth can cause erosion of tooth enamel, tissue irritations such as sores or inflammation, and possible fractures of crowns. Stomach acid is normally in the range of 1.2- 3.5 (VERY acidic), while the oral cavity averages around 6.2-7.5 (neutral). Erosion of tooth enamel occurs around a pH of 5.7.

Erosion-1.jpg

The white arrows are pointing to all of the areas of acid erosion on the tongue side of this person’s teeth! That is a lot of wear!

One of the many purposes of saliva is to rinse the mouth of any irregularity such as acids (and bases). The process of remineralization from saliva takes about 20 minutes after exposure. This means, once your mouth is exposed to acids through eating, drinking, or acid reflux, it takes the saliva (without the help of mouth rinses) about 20 minutes to bring the acidity level in the mouth back to a non-damaging level. Unfortunately, when the acids from the stomach flourish for long periods of time the saliva is unable to neutralize the acid and erosion can occur.

Why is erosion a big deal? With acid  (or any type of) erosion, the teeth become thin, brittle, sensitive, and unprotected from the external environment. Erosion removes the strong enamel layer of the teeth and exposes the softer dentin layer that is easily broken down. The dentin layer exposes tiny ‘pores’ in the teeth that make changes in the oral environment sensitive. This is why some people experience temperature sensitivity. The ‘pores’ of the teeth are similar to very tiny tunnels that lead to the nerve of the tooth causing ‘flare-ups’ when drinking cold water.

enamel-and-dentin.png

The ‘Enamel’ is the strong protective layer of the teeth, the ‘Dentin’ is the softer layer below the enamel. This picture shows a damaged tooth with the two layers exposed.

With the enamel layer being depleted, the integrity or strength of the teeth is very small. I will often see patients that have broken, cracked or painful teeth due to having ‘thin’ enamel. With the thinner and weaker tooth structure, eating becomes complicated. Taking a bite out of firm foods such as apples, carrots, or some steaks could cause fractures to the teeth. Once breakage occurs dental treatments such as fillings, crowns, implants, and veneers are required for optimal comfort and to prevent further damage. Thin enamel also causes yellowing or other discoloration of the teeth!

Thankfully, there are things you can do to help protect the teeth! I recommend always rinsing with a plain warm water rinse after eating and drinking anything. The water will aid saliva in the neutralizing of the mouth and it is VERY inexpensive. There are also numerous products I recommend using if you have a ‘high acidity’ diet. “CloSYS” is my number one recommended mouth rinse to help reduce the cavity risk and decrease acid levels in the mouth. I have numerous patients that have great results with this product, and it is relatively inexpensive for being a specialty rinse. I also recommend ACT Alcohol Free Anticavity Fluoride Rinse. ACT rinse has great remineralizing properties. My final recommendation would be to discuss your acid reflux with your primary care physician. Fortunately, there are quite a few solutions to help reduce the symptoms associated with acid reflux!

As always, I welcome ANY of your dental questions! Hopefully, this information and all of these recommendations can help! As always, If you have any questions or concerns don’t be afraid to post a comment or send an email! I am always happy to answer your burning dental questions. Have a great day, and don’t forget to smile today!

-DentalBritt

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Gettin’ Flossy

Gettin’ Flossy

Hello again! Today I am diving deep into patient needs with proper ways to care for your oral health through flossing! I realize, as unfortunate as it is, not everyone flosses, brushes, or visits their oral health care provider as often as they should. Although I would love to live in a perfect world, I know we don’t, and many people try to avoid the dentist as long as possible. Way too much of the world’s population assume nothing is hurting, so that must mean nothing is wrong, infected, or potentially damaged. With this in mind, I am going to help those of you who don’t already know (especially those who think they know and don’t) make your home oral care as efficient and preventative of disease as possible.

Starting off, I’m sure I can safely assume (most) people hate flossing… It’s not just you; and Yes, we know you probably “don’t floss as often as you should” however, that doesn’t make it alright. Bottom line, as dental professionals, most of us really do care if you’re flossing or not. We are not just giving you a hard time about it because our years of schooling told us to. Yes, of course, we would like to see each patient having a perfect oral health routine, brushing morning and night, with flossing, and possibly using mouth rinse once daily. Thankfully they are your teeth, and your teeth only; meaning if they fall out due to disease, we can confidentially say “we told you so”. Certainly, as professionals, I would hope no one actually tells you this, and even more so, I hope that does not actually happen.

The fact of the matter is, flossing not only removes 33% more bacteria from the teeth that your toothbrush alone cannot reach, but it increases blood flow to the tissue. This increased blood flow helps red and white blood cells filter through the oral cavity and decreasing your chance of disease.

It is recommended that people floss, then brush, then clean the tongue, and finally use a mouth rinse, if preferred. Although this is the ‘technical’ routine process, as long as you are performing each task, on a regular (daily), basis we will be happy. 

Starting off with flossing, the ‘gold standard’ I would say is using traditional, string floss.

String Dental Floss

Unfortunately, not everyone has the physical ability or patience to use this floss, and most dental professionals can understand that. People get busy, or lazy, or they truly cannot figure out how to perform the act of flossing without hurting their gums. Thankfully, that is not your only option. A second recommendation would be to use floss attached to some sort of handle such as the ones pictured in white and green. These are great not only for getting food debris out of between teeth but to ‘massage’ the gums. Yes, you read that right, Massage! 

Dental Flossers

The act of flossing does massage the gums, that is the ‘increasing blood flow’ I was talking about earlier. These are not the only flossing options, either. If you are shopping at your local drug store for other dental products such as toothpaste, take a gander at the floss options. If anything looks strange, take a quick picture, and send it with a question on how to use the dang thing. You’ll be surprised at how many options there are!

Yet another option would be to invest in a water pick. Water picks are used either in conjunction or in place of flossing. They are great for those who cannot properly floss due to dexterity or some other limitation. Water flossers are a great option for those with braces or permanent retainers as well. Although water flossers do not have a string that can help clean the teeth, it uses a pulsating water jet to rinse bacteria and plaque away from the gums.

With a water flosser, It is recommended that you hold the stream of water at a 90° or perpendicular angle to the tooth and gums. Then follow the horseshoe shape of the gums making sure to focus between the teeth. For better instruction, I will provide a video of each task. 

When flossing, select a floss you feel comfortable controlling. I personally like a woven floss that is similar to yarn. Although the tiny fibers may be caught in between my teeth, I feel it is the most effective in plaque removal. Once you find a floss you can commit to, wrap that floss around the middle finger of each hand, and use your index finger and thumb to control the movement. Gently glide the floss between the teeth ensuring to not cut your gums. pull the floss against the tooth you intend to clean making a “C” shape with the floss, and slide up and down the tooth until all debris is removed. Continue to perform this action until all the teeth are cleaned.

Flossing Technique

I know there is a lot of instruction here just for flossing, but I believe in you and your ability to improve your oral health! 

As always, If you have any questions, or concerns don’t be afraid to post a comment or send an email! I am always happy to answer your burning dental questions. Have a great day, and don’t forget to smile today! 

-DentalBritt